HERPESVIRUS BRAIN DISEASES
DOI:
https://doi.org/10.11603/1681-2727.2025.1.15154Keywords:
herpes encephalitis, encephalopathy, acute disseminated encephalomyelitis, prognosis, clinical casesAbstract
Herpes simplex virus (HSV) and varicella virus (VZV) are among the most frequently diagnosed infectious causes of sporadic encephalitis in the world. Despite treatment, morbidity and mortality rates remain high, especially in HSV encephalitis. Thus, the mortality rate from both HSV and VZV encephalitis ranges from 5 to 20 %, and the rate of complete recovery ranges from 14 to 43 % for HSV encephalitis and from 33 to 49 % for VZV encephalitis. Prognostic factors for both HSV and VZV encephalitis include older age and comorbidity, as well as severity and extent of the lesion on magnetic resonance imaging (MRI) at the time of admission, and delay in initiating treatment for encephalitis.
References
Venkatesan, A., Tunkel, A. R., Bloch, K. C., Lauring, A. S., Sejvar, J., Bitnun, A., ... & Cherry, J. (2013). Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clinical Infectious Diseases, 57(8), 1114-1128. doi: 10.1093/cid/cit458 DOI: https://doi.org/10.1093/cid/cit458
Boucher, A., Herrmann, J. L., Morand, P., Buzelé, R., Crabol, Y., Stahl, J. P., & Mailles, A. (2017). Epidemiology of infectious encephalitis causes in 2016. Médecine et maladies infectieuses, 47(3), 221-235. doi: 10.1016/j.medmal.2017.02.003 DOI: https://doi.org/10.1016/j.medmal.2017.02.003
Auli Verkkoniemi-Ahola. (2017). Настанова 00774. Енцефаліт. Настанови на засадах доказової медицини. Створені DUODECIM Medical Publications, Ltd. Retrieved from https://guidelines.moz.gov.ua/documents/3557
Poissy, J., Champenois, K., Dewilde, A., Melliez, H., Georges, H., Senneville, E., & Yazdanpanah, Y. (2012). Impact of Herpes simplex virus load and red blood cells in cerebrospinal fluid upon herpes simplex meningo-encephalitis outcome. BMC Infectious Diseases, 12, 1-6. doi: 10.1186/1471-2334-12-356 DOI: https://doi.org/10.1186/1471-2334-12-356
Ungureanu, A., Van der Meer, J., Bicvic, A., Abbuehl, L., Chiffi, G., Jaques, L., ... & Dietmann, A. (2021). Meningitis, meningoencephalitis and encephalitis in Bern: an observational study of 258 patients. BMC neurology, 21, 1-11. doi: 10.1186/s12883-021-02502-3 DOI: https://doi.org/10.1186/s12883-021-02502-3
Steiner, I., Kennedy, P. G., & Pachner, A. R. (2007). The neurotropic herpes viruses: herpes simplex and varicella-zoster. The Lancet Neurology, 6(11), 1015-1028. DOI: https://doi.org/10.1016/S1474-4422(07)70267-3
Granerod, J., Cousens, S., Davies, N. W., Crowcroft, N. S., & Thomas, S. L. (2013). New estimates of incidence of encephalitis in England. Emerging Infectious Diseases, 19(9), 1455. doi: 10.3201/ eid1909.130064 DOI: https://doi.org/10.3201/eid1909.130064
Kennedy, P.G.E. (2005). Вірусний енцефаліт: причини, диференціальна діагностика і лікування. Медицина світу, 4.
Bradshaw, M. J., & Venkatesan, A. (2016). Herpes simplex virus-1 encephalitis in adults: pathophysiology, diagnosis, and management. Neurotherapeutics, 13(3), 493-508. doi: 10.1007/s13311-016-0433-7 DOI: https://doi.org/10.1007/s13311-016-0433-7
Singh, T. D., Fugate, J. E., Hocker, S., Wijdicks, E. F., Aksamit, A. J., & Rabinstein, A. A. (2016). Predictors of outcome in HSV encephalitis. Journal of neurology, 263, 277-289. doi: 10.1007/ s00415-015-7960-8 DOI: https://doi.org/10.1007/s00415-015-7960-8
Sarton, B., Jaquet, P., Belkacemi, D., de Montmollin, E., Bonneville, F., Sazio, C., ... & ENCEPHALITICA Consortium. (2021). Assessment of magnetic resonance imaging changes and functional outcomes among adults with severe herpes simplex encephalitis. JAMA Network Open, 4(7), e2114328-e2114328. doi: 10.1001/jamanetworkopen.2021.14328 DOI: https://doi.org/10.1001/jamanetworkopen.2021.14328
Abbuehl, L. S., Hofmann, E., Hakim, A., & Dietmann, A. (2023). Can we forecast poor outcome in herpes simplex and varicella zoster encephalitis? A narrative review. Frontiers in neurology, 14, 1130090. DOI: https://doi.org/10.3389/fneur.2023.1130090
Tan, I. L., McArthur, J. C., Venkatesan, A., & Nath, A. (2012). Atypical manifestations and poor outcome of herpes simplex encephalitis in the immunocompromised. Neurology, 79(21), 2125-2132. doi: 10.1212/WNL.0b013e3182752ceb DOI: https://doi.org/10.1212/WNL.0b013e3182752ceb
Stahl, J. P., Mailles, A., & de Broucker, T. (2012). Herpes simplex encephalitis and management of acyclovir in encephalitis patients in France. Epidemiology & Infection, 140(2), 372-381. doi: 10.1017/S0950268811000483 DOI: https://doi.org/10.1017/S0950268811000483
Jouan, Y., Grammatico-Guillon, L., Espitalier, F., Cazals, X., François, P., & Guillon, A. (2015). Long-term outcome of severe herpes simplex encephalitis: a population-based observational study. Critical Care, 19, 1-9. doi: 10.1186/s13054-015-1046-y DOI: https://doi.org/10.1186/s13054-015-1046-y
Cag, Y., Erdem, H., Leib, S., Defres, S., Kaya, S., Larsen, L., ... & Elaldi, N. (2016). Managing atypical and typical herpetic central nervous system infections: results of a multinational study. Clinical microbiology and infection, 22(6), 568-e9. doi: 10.1016/j.cmi.2016.03.027 DOI: https://doi.org/10.1016/j.cmi.2017.01.016
de Montmollin, E., Dupuis, C., Jaquet, P., Sarton, B., Sazio, C., Susset, V., ... & ENCEPHALITICA Study Group. (2022). Herpes simplex virus encephalitis with initial negative polymerase chain reaction in the cerebrospinal fluid: prevalence, associated factors, and clinical impact. Critical Care Medicine, 50(7), e643-e648. doi: 10.1097/CCM.0000000000005485 DOI: https://doi.org/10.1097/CCM.0000000000005485
Mulatero, M., Boucekine, M., Felician, O., Boussen, S., Kaplanski, G., Rossi, P., ... & Kaphan, E. (2022). Herpetic encephalitis: which treatment for which body weight?. Journal of Neurology, 269(7), 3625-3635. doi: 10.1007/s00415-022-10981-8 DOI: https://doi.org/10.1007/s00415-022-10981-8
Müller-Jensen, L., Zierold, S., Versluis, J. M., Boehmerle, W., Huehnchen, P., Endres, M., ... & Heinzerling, L. M. (2022). Characteristics of immune checkpoint inhibitor-induced encephalitis and comparison with HSV-1 and anti-LGI1 encephalitis: a retrospective multicentre cohort study. European Journal of Cancer, 175, 224-235. doi: 10.1016/j.ejca.2022.08.009 DOI: https://doi.org/10.1016/j.ejca.2022.08.009
Gnann Jr, J. W., Sköldenberg, B., Hart, J., Aurelius, E., Schliamser, S., Studahl, M., ... & Whitley, R. J. (2015). Herpes simplex encephalitis: lack of clinical benefit of long-term valacyclovir therapy. Clinical Infectious Diseases, 61(5), 683-691. doi: 10.1093/cid/civ369 DOI: https://doi.org/10.1093/cid/civ369
Jørgensen, L. K., Dalgaard, L. S., Østergaard, L. J., Nørgaard, M., & Mogensen, T. H. (2017). Incidence and mortality of herpes simplex encephalitis in Denmark: a nationwide registry-based cohort study. Journal of Infection, 74(1), 42-49. doi: 10.1016/j.jinf.2016.09.004 DOI: https://doi.org/10.1016/j.jinf.2016.09.004
Jaquet, P., De Montmollin, E., Dupuis, C., Sazio, C., Conrad, M., Susset, V., ... & ENCEPHALITICA study group. (2019). Functional outcomes in adult patients with herpes simplex encephalitis admitted to the ICU: a multicenter cohort study. Intensive Care Medicine, 45, 1103-1111. doi: 10.1007/ s00134-019-05684-0 DOI: https://doi.org/10.1007/s00134-019-05684-0
Whitfield, T., Fernandez, C., Davies, K., Defres, S., Griffiths, M., Hooper, C., ... & Solomon, T. (2021). Protocol for DexEnceph: a randomised controlled trial of dexamethasone therapy in adults with herpes simplex virus encephalitis. BMJ open, 11(7), e041808. doi: 10.1136/bmjopen-2020-041808 DOI: https://doi.org/10.1136/bmjopen-2020-041808
Meyding-Lamadé, U., Jacobi, C., Martinez-Torres, F., Lenhard, T., Kress, B., Kieser, M., ... & Craemer, E. (2019). The German trial on Aciclovir and Corticosteroids in Herpes-simplex-virus-Encephalitis (GACHE): a multicenter, randomized, double-blind, placebo-controlled trial. Neurological Research and Practice, 1, 1-9. doi: 10.1186/s42466-019-0031-3 DOI: https://doi.org/10.1186/s42466-019-0031-3
Nagel, M. A., Niemeyer, C. S., & Bubak, A. N. (2020). Central nervous system infections produced by varicella zoster virus. Current Opinion in Infectious Diseases, 33(3), 273-278. doi: 10.1097/ QCO.0000000000000647 DOI: https://doi.org/10.1097/QCO.0000000000000647
Armangue, T., Spatola, M., Vlagea, A., Mattozzi, S., Cárceles-Cordon, M., Martinez-Heras, E., ... & Zabalza, A. (2018). Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis. The Lancet Neurology, 17(9), 760-772. doi: 10.1016/ S1474-4422(18)30244-8 DOI: https://doi.org/10.1016/S1474-4422(18)30244-8
Westman, G., Aurelius, E., Ahlm, C., Blennow, K., Eriksson, K., Lind, L., ... & Studahl, M. (2021). Cerebrospinal fluid biomarkers of brain injury, inflammation and synaptic autoimmunity predict long-term neurocognitive outcome in herpes simplex encephalitis. Clinical Microbiology and Infection, 27(8), 1131-1136. doi: 10.1016/j.cmi.2020.09.031 DOI: https://doi.org/10.1016/j.cmi.2020.09.031
Omland, L. H., Vestergaard, H. T., Dessau, R. B., Bodilsen, J., Andersen, N. S., Christiansen, C. B., ... & Obel, N. (2021). Characteristics and long-term prognosis of Danish patients with varicella zoster virus detected in cerebrospinal fluid compared with the background population. The Journal of infectious diseases, 224(5), 850-859. doi: 10.1093/infdis/jiab013 DOI: https://doi.org/10.1093/infdis/jiab013
Kaewpoowat, Q., Salazar, L., Aguilera, E., Wootton, S. H., & Hasbun, R. (2016). Herpes simplex and varicella zoster CNS infections: clinical presentations, treatments and outcomes. Infection, 44, 337-345. doi: 10.1007/s15010-015-0867-6 DOI: https://doi.org/10.1007/s15010-015-0867-6
Le Bot, A., Ballerie, A., Pronier, C., Bénézit, F., Reizine, F., Tas, M., ... & Tattevin, P. (2021). Characteristics and outcome of varicella-zoster virus central nervous system infections in adults. European Journal of Clinical Microbiology & Infectious Diseases, 40(11), 2437-2442. doi: 10.1007/s10096-021-04245-y DOI: https://doi.org/10.1007/s10096-021-04245-y
Lenfant, T., L’Honneur, A. S., Ranque, B., Pilmis, B., Charlier, C., Zuber, M., ... & Michon, A. (2022). Neurological complications of varicella zoster virus reactivation: prognosis, diagnosis, and treatment of 72 patients with positive PCR in the cerebrospinal fluid. Brain and Behavior, 12(2), e2455. doi: 10.1002/brb3.2455 DOI: https://doi.org/10.1002/brb3.2455
Jennett, B., & Bond, M. (1975). Assessment of outcome after severe brain damage: a practical scale. The Lancet, 305(7905), 480-484. doi: 10.1016/S0140-6736(75)92830-5 DOI: https://doi.org/10.1016/S0140-6736(75)92830-5
Yan, Y., Yuan, Y., Wang, J., Zhang, Y., Liu, H., & Zhang, Z. (2022). Meningitis/meningoencephalitis caused by varicella zoster virus reactivation: a retrospective single-center case series study. American Journal of Translational Research, 14(1), 491.
Rottenstreich, A., Oz, Z. K., & Oren, I. (2014). Association between viral load of varicella zoster virus in cerebrospinal fluid and the clinical course of central nervous system infection. Diagnostic microbiology and infectious disease, 79(2), 174-177. doi: 10.1016/j.diagmicrobio.2014.02.015 DOI: https://doi.org/10.1016/j.diagmicrobio.2014.02.015
Růžek, D., Piskunova, N., & Žampachová, E. (2007). High variability in viral load in cerebrospinal fluid from patients with herpes simplex and varicella-zoster infections of the central nervous system. Clinical microbiology and infection, 13(12), 1217-1219. doi: 10.1111/j.1469-0691.2007.01831.x DOI: https://doi.org/10.1111/j.1469-0691.2007.01831.x
Corral, C., Quereda, C., Muriel, A., Martínez-Ulloa, P. L., González-Gómez, F. J., & Corral, Í. (2020). Clinical spectrum and prognosis of neurological complications of reactivated varicella-zoster infection: the role of immunosuppression. Journal of Neurovirology, 26, 696-703. doi: 10.1007/s13365-020-00872-x DOI: https://doi.org/10.1007/s13365-020-00872-x
Lee, G. H., Kim, J., Kim, H. W., & Cho, J. W. (2021). Herpes simplex viruses (1 and 2) and varicella-zoster virus infections in an adult population with aseptic meningitis or encephalitis: A nine-year retrospective clinical study. Medicine, 100(46), e27856. doi: 10.1097/MD.0000000000027856 DOI: https://doi.org/10.1097/MD.0000000000027856
Mirouse, A., Sonneville, R., Razazi, K., Merceron, S., Argaud, L., Bigé, N., ... & Canet, E. (2022). Neurologic outcome of VZV encephalitis one year after ICU admission: a multicenter cohort study. Annals of Intensive Care, 12(1), 32. doi: 10.1186/s13613-022-01002-y DOI: https://doi.org/10.1186/s13613-022-01002-y
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